Affordable and Easily Accessible Ultra-Processed Foods Double Obesity Trends in Children and Adolescents

JAKARTA – Low- and middle-income countries are experiencing the sharpest increase in overweight or obesity among school-age children and adolescents.

The UNICEF report, "Child Nutrition Report 2025 – Feeding Profit: How food environments are failing children," reveals that low- and middle-income countries have experienced a rapid increase in obesity prevalence over the past two decades.

For example, the prevalence of obesity among children and adolescents aged 5-19 tripled between 2000 and 2022, reaching a moderate level (from 15 percent to less than 25 percent) in nine countries, five of which are in South Asia: Bhutan, the Democratic Republic of the Congo, Indonesia, Liberia, the Maldives, Pakistan, Sri Lanka, and Vietnam.

This surge in obesity is due to the widespread exposure of the retail industry to unhealthy foods, such as cheap snacks, ultra-processed foods, and sugary drinks.

"When we talk about malnutrition, we are no longer just talking about underweight children," said UNICEF Executive Director Catherine Russell in the report.

"Obesity is a growing problem that can impact children's health and development," she continued.

Ultra-processed foods are increasingly replacing fruits, vegetables, and protein, even though nutrition plays a vital role in children's growth, cognitive development, and mental health.

The Prevalence of Obesity is Increasing Sharply

Obesity occurs when a person has excess fat accumulation that poses a health risk, according to the World Health Organization (WHO). Children are considered overweight when they are “significantly heavier than a healthy weight for their age, sex, and height,” notes UNICEF.

According to data from more than 190 countries, researchers found that in the past 25 years, the number of obese children has doubled from 194 million to 391 million. Some countries have experienced a higher increase in obesity than others.

In South Asia, the region with the lowest obesity prevalence in 2000, the prevalence increased almost fivefold by 2022.

The prevalence of obesity in children and adolescents was previously prevalent in high-income countries. However, since 2000, the prevalence has more than doubled in low- and middle-income countries. As a result, the prevalence gap has narrowed, and low- and middle-income countries now account for 81 percent of the global obesity burden, up from 66 percent in 2000.

According to UNICEF, in low-income countries, children are more likely to be obese if they come from wealthier households, which can afford more food, including energy-dense foods.

In countries transitioning to middle-income status, ultra-processed foods and beverages have become more widely available and affordable, increasing the prevalence of obesity among children at all household income levels.

Conversely, in high-income countries, poor and unhealthy diets are a marker of poverty, not prosperity. And childhood obesity tends to be more common among children and adolescents from poorer households.

Impact of Obesity

Cheap, ultra-processed foods and beverages are flooding retail markets and infiltrating schools. Global sales of ultra-processed foods and beverages are increasing sharply, driven by rapid growth in middle-income countries, where modern retail outlets, online grocery stores, and food delivery apps are thriving.

These ultra-processed foods and beverages also tend to be relatively more accessible than nutritious, fresh or minimally processed foods.

There is a high price to pay when obesity affects children and adolescents. Unhealthy diets not only increase the risk of obesity but also other cardiometabolic conditions, including high blood pressure, elevated blood glucose, and abnormal blood lipid levels.

These health problems can persist into adulthood, increasing the risk of non-communicable diseases, including type 2 diabetes, cardiovascular disease, and some cancers.

Excess weight is also associated with low self-esteem, anxiety, and depression. Parents bear the emotional burden of their children's mental health challenges. This obesity problem can persist and can have financial consequences.

"Parents bear a financial burden due to typically higher medical costs and lost income from caring for them," the UNICEF report states.

"Economies worldwide are struggling with rising healthcare costs and declining labor productivity due to rising overweight and obesity," it continues.

Double Nutrient Problem in Indonesia

The World Obesity Federation estimates that Indonesia has one of the highest rates of obesity in the world, after China, India, and the United States. It is estimated that 206 million children and adolescents aged 5-19 will be living with obesity by 2025, and 254 million by 2030.

In May 2024, in a national webinar entitled "Obesity in Children and Adolescents in Indonesia: Current Conditions and Challenges," Indi Dharmayanti, Head of the National Agency for Research and Development (BRIN), explained in her remarks that Indonesia is currently experiencing a nutritional transition characterized by a still high prevalence of undernutrition, while overnutrition, in the form of overweight and obesity, is also showing an increasing trend. This situation is known as the problem of "double nutrition."

"Efforts to address obesity in children and adolescents in Indonesia tend to stagnate. Data from the 2023 Indonesian Health Survey shows that the prevalence of overweight and obesity is around 19.7 percent in children aged 5-12 and 16 percent in children aged 13-15," said Indi.

These results are not significantly different from the 2018 Basic Health Research, which respectively recorded rates of 19.8 percent and 16.2 percent in the same age groups.

Echoing Indi's sentiments, Wahyu Pudji Nugraheni, Head of the National Agency for Research on Public Health and Nutrition at BRIN, stated that Indonesia still faces the triple burden of nutritional problems: malnutrition, overnutrition (obesity), and micronutrient deficiencies. These nutritional problems, which affect children and adolescents, could threaten the realization of the Golden Indonesia 2045 vision.

Wahyu stated that if efforts are slow to address these issues, the dominant risk factors for overweight and obesity in children and adolescents will be environmental factors, such as high-energy food intake and low physical activity.